Provider Demographics
NPI:1043355910
Name:CHAUDHRY, TAIMUR L (MD)
Entity type:Individual
Prefix:DR
First Name:TAIMUR
Middle Name:L
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E. CHURCH STREET
Mailing Address - Street 2:ATTENTION: MEDICAL STAFF OFFICE
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-739-3954
Mailing Address - Fax:805-739-3060
Practice Address - Street 1:220 S PALISADE DR STE 203
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8903
Practice Address - Country:US
Practice Address - Phone:805-354-7101
Practice Address - Fax:805-354-7102
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP21275207V00000X
MDD0069607207V00000X
CAC153890207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS581Medicare PIN
MD163659ZCDMedicare PIN